Pre-Natal Care Goes Mobile in Uganda

KAMPALA —  In Uganda, three students have invented a smartphone application that can measure the heartbeat of a fetus. The device could improve prenatal care in rural clinics, and may even help prevent deaths during childbirth.

Joshua Okello’s first love was medicine. He studied to be a doctor before quitting to pursue his second love: technology. However, his interest in medicine never left him. Last year, Okello and two other students at Kampala’s Makerere University invented a smartphone application that they think could change the face of maternal health care in Africa.

The app is called a WinSenga - “senga” is the local term for an aunt who helps out during pregnancy. It consists of a tiny microphone in a plastic horn, based on the Pinard horn used by midwives for centuries.

“It’s a long cone-shaped device with a hole through it and a flat top. The midwife places it on the belly and listens in. Every midwife in this country has seen it, and that is what they are trained with,” said Okello.

The sound the horn picks up is fed into a smartphone that records and analyzes the fetal heartbeat. From there, said Okello, the WinSenga suggests different courses of action.

“Say you have a baby and we detect that the heartbeat is less than 120 beats per minute. That is a problem. So immediately, we pop up something that says ‘Please, we suggest that you could do A, B, C, D,’” explained Okello.

The device is not yet fully functional, but last year Okello and his partners won a $50,000 grant from Microsoft - the “Win” in WinSenga is short for Windows. They are now developing their app from a Microsoft-funded technology incubator at the university, set up to encourage Uganda’s nascent tech sector.

Having a mobile device could make it easier for health care workers to reach women in remote villages, said Okello. The final result should also be cheaper than the machines currently in use.

“We are getting a solution that’s cheaper, which means that more clinics are going to get it. If we could get Huawei or I don’t know who to give us phones for free, we are looking at a solution that’s less than $100,” said Okello.

Juliet Birungi, an obstetrician who has tried the WinSenga, says she sees another use for it. In understaffed hospitals like the one she works in, she says, the WinSenga could be even more helpful if it is attached to a mother’s belly during labor and delivery, monitoring the state of the baby.

“You have so many mothers in labor, and we do not have enough staff. You find that while the mother is laboring here, the other one is delivering, the other one is bleeding. So when you come, you are able to look at the recording,” said Birungi.

An abnormal fetal heart rate can be a warning sign of labor complications, and could mean the difference between life and death, says Birungi. Uganda’s maternal mortality rate is so high, she adds, that a machine can only do so much.

“Just like all devices, they do not replace the need for a human being who is skilled. The need is still there, and it’s real and it has to be worked upon. But this device would make their work easier, and the outcome would be much better,” said Birungi.

The app could easily be adapted to other developing countries with similar problems, thinks Okello. With a little tweaking, he adds, it could even be used at home by pregnant women in developed countries.

For the moment, however, he and his team are busy preparing for a clinical trial in January, when WinSenga will finally be put to the test.